Endoscopes are routinely used to provide direct visualization to medical personnel while performing medical procedures. To enable medical personnel to reach smaller portions of the anatomy, medical personnel often use a mother-baby scope technique. Baby scopes are either fiber optic ocular lens scopes or electronic, and they typically have an outer diameter of 3.5 mm. Using a mother-baby scope technique, a baby scope is directed through a working channel of an endoscope, such as a forward-viewing gastroscope or a side-view duodenoscope, and thereafter directed to the targeted anatomy.
For example, endoscopic retrograde cholangiopancreatography (ERCP) is a commonly used endoscopic procedure to both diagnose and treat ailments of both the pancreatic and bile duct systems. Often, a side-viewing endoscope (duodenoscope) is advanced to the duodenum and in line with the ampulla of Vater (papilla) to facilitate diagnostic and therapeutic catheter-based procedures. A method to gain direct visualization of the bile and pancreatic ducts is use of a mother scope/baby scope system where the mother scope is a duodenoscope and the baby scope is a choledochoscope that is passed through the accessory channel of the duodenoscope.
The mother-baby scope approach presents numerous problems and issues. For example, the technique is difficult to use for a number of reasons, including but not limited to, requiring two sets of operators, two sets of equipment, and accordingly, additional resources. Moreover, due to the outer diameter size of the mother scope and the baby scope, the possible anatomical areas able to be visualized and treated by such an approach are limited.
Alternatively, rather than use a mother-baby scope approach, a slim scope may be considered. A slim scope has an outer diameter of approximately 5-7 mm, and therefore, it cannot be passed through the accessory channel of a duodenoscope. Instead, an overtube is used to provide structure for the slim scope to facilitate cannulation into the papilla.
The slim-scope approach presents numerous problems and issues. The technique is difficult to use for a number of reasons. For example, the overtubes that are used in conjunction with the slim scope cannot bend where the slim scope exits at the distal end of the overtube, nor can the distal end of the overtubes be held in a fixed position. As a result, the slim scope often falls out of the bile duct or other targeted anatomy because of its extra weight compared to a lighter baby scope.